Novo Nordisk is advancing a strategic plan to reinvigorate growth beyond its current bestsellers, Wegovy and Ozempic, amid looming patent expirations in the early 2030s. The Danish drugmaker unveiled ambitions at its recent Capital Markets Day to diversify its pipeline with potential blockbuster treatments that move beyond obesity and diabetes. However, investors reacted skeptically, questioning Novo’s growth projections which align merely with industry averages, and expressing concern over a lack of immediate turnaround clarity. Meanwhile, Eli Lilly is gaining ground in the obesity market, especially with its emerging oral weight loss pill segment.

Novo’s CEO Mike Doustdar highlighted the early uptake of their Wegovy pill, launched ahead of Lilly’s Foundayo, suggesting a shift in patient preference from injections to oral forms could drive significant growth in the obesity pill market by the end of the decade. Conversely, Lilly’s CEO Dave Ricks reported that Foundayo is quickly expanding its share among oral GLP-1 patients in the U.S., supported by strong commercial capabilities. Lilly is also establishing dominance in the newly covered Medicare obesity drug market, where its drugs account for 70% of patient use, and claims a 61% share of the U.S. GLP-1 market, compared to Novo’s 39%.

Analysts note Lilly’s structural advantages, including its commercial reach and an advancing pipeline with promising candidates beyond existing drugs. These include retatrutide, a triple-agonist drug targeting multiple gut hormones, and a novel weekly injection addressing a different receptor pathway critical in appetite control, offering new options for patients who do not respond well to current GLP-1 treatments. Lilly’s Foundayo, a small-molecule pill easier to manufacture and scale than peptide-based drugs like Wegovy, is predicted to dominate the global oral obesity drug market, despite its somewhat lower average weight loss compared to Novo’s offerings.

For Novo, the challenge lies in proving that its next-generation pipeline can both replace the revenue lost from expiring patents on Wegovy and Ozempic and keep pace with Lilly’s advances. Key projects include CagriSema, a combination drug expected next year, and other obesity treatments slated for 2028 and beyond. Novo aims to increase patient reach tenfold by 2030 and scale manufacturing to meet growing demand, with plans to have pills capture up to half of the global obesity drug market. However, investor concerns persist over pricing sustainability and the company’s ability to sustain premium prices and growth levels in a market that is rapidly evolving and increasingly competitive.